Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 2250351 | NY |
NPI | 1023083607 |
---|---|
Provider Name | Nirav D Shah |
First Address | Poughkeepsie, NY 12601-1173 |
Second Address | Newburgh, NY 12550-1797 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2006 |
Last Update Date | 28/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02735739 | (05) | NY |